IMreasoning - Clinical reasoning for Doctors and StudentsSun, 31 May 2020 04:15:03 +0000Sun, 07 Jun 2020 04:21:28 +0000Libsyn WebEngine 2.0http://imreasoning.com
enhttp://imreasoning.comimreasoning@gmail.com (imreasoning@gmail.com)https://ssl-static.libsyn.com/p/assets/1/e/b/7/1eb73903f0496016/PHOTO-2020-03-20-14-40-03.jpgIMreasoning - Clinical reasoning for Doctors and StudentsDrs. Art Nahill & Nic Szecketclinicalreasoning,generalmedicine,internalmedicine,md,registrar,studentdoctorcleanepisodichttps://imreasoning.libsyn.com/rss61: Cognitive AutopsySun, 31 May 2020 04:15:03 +0000Once again we dissect a diagnosis-gone-wrong from the records of the Health and Disability Commissioner. Can we learn something to take away and avoid making the same mistake ourselves?]]>Once again we dissect a diagnosis-gone-wrong from the records of the Health and Disability Commissioner. Can we learn something to take away and avoid making the same mistake ourselves?]]>49:46nofullEpisode 60: STC with Josh InglisSun, 19 Apr 2020 04:17:31 +0000Welcome to another STC where friend of the podcast, Josh Inglis, challenges us with a case from Australia. Play along with us and try to get the diagnosis as early as possible.

As an aside, our update regarding COVID19 in NZ is already a bit out date. Time move quickly during a pandemic! NZ has not only managed to "flatten the curve"; we have completely squashed it. For each of the last 4 days we have had less than 15 new confirmed and probable cases. Now we have to figure out how to stay COVID-free until the vaccine...

]]>Welcome to another STC where friend of the podcast, Josh Inglis, challenges us with a case from Australia. Play along with us and try to get the diagnosis as early as possible.

As an aside, our update regarding COVID19 in NZ is already a bit out date. Time move quickly during a pandemic! NZ has not only managed to "flatten the curve"; we have completely squashed it. For each of the last 4 days we have had less than 15 new confirmed and probable cases. Now we have to figure out how to stay COVID-free until the vaccine...

]]>01:17:47nofull59: CoronavirusFri, 20 Mar 2020 05:50:00 +0000First, welcome to Madison and Steven who have joined the IMreasoning team!

Like everyone else, we're talking about the Coronavirus. Its hard not to when it has taken over essentially every aspect of our daily lives, both at work and at home.

We talk about what makes the situation difficult for human minds to grasp the reality of this pandemic; the concept of exponential growth, denial in hard times, and the counterfactual.

And we have the rare treat of chatting with our good friend Jorge Valbuena-Balbas who is living and working in Bilbao, Spain, and is currently sitting (metophorically-speaking) at the bottom of what appears to be an exponential trajectory in Spain.

]]>First, welcome to Madison and Steven who have joined the IMreasoning team!

Like everyone else, we're talking about the Coronavirus. Its hard not to when it has taken over essentially every aspect of our daily lives, both at work and at home.

We talk about what makes the situation difficult for human minds to grasp the reality of this pandemic; the concept of exponential growth, denial in hard times, and the counterfactual.

And we have the rare treat of chatting with our good friend Jorge Valbuena-Balbas who is living and working in Bilbao, Spain, and is currently sitting (metophorically-speaking) at the bottom of what appears to be an exponential trajectory in Spain.

]]>01:01:51nofull58: STC - Human Dx Global Morning ReportThu, 05 Mar 2020 04:19:32 +0000Another instalment of STC, this time using a Global Morning Report case from HumanDx. We hope to do more of these as we initiate a collaboration with the Human Dx team.

Big news! We have launched our Patreon page. Listen to this episode to hear more about how you can support the podcast. You can use the link below to visit our Patreon page:

]]>36:38nofull57: Bayesian ReasoningSun, 09 Feb 2020 05:34:46 +0000In this episode we review Bayesian Reasoning in general, and Nic get's the opportunity to geek out on talking stats. We cover likelihood ratios, positive and negative predictive values, sensitivity and specificity, and pre- and post-test probabilities. Hopefully, we used examples that will help you understand and remember these concepts.]]>In this episode we review Bayesian Reasoning in general, and Nic get's the opportunity to geek out on talking stats. We cover likelihood ratios, positive and negative predictive values, sensitivity and specificity, and pre- and post-test probabilities. Hopefully, we used examples that will help you understand and remember these concepts.]]>46:00nofull56: We're back!Mon, 13 Jan 2020 09:13:17 +0000Well folks, we are finally ready to re-launch with "season 2". During our break we have been making plans to continue bringing you new material. But most importantly we've decided to launch a new podcast called "Diagnostica" which aims to bridge the gap between the culture of medicine and the "public". We'll keep you updated on this new project.

For now, enjoy a short cognitive autopsy. Next episode, more Bayesian math!

]]>Well folks, we are finally ready to re-launch with "season 2". During our break we have been making plans to continue bringing you new material. But most importantly we've decided to launch a new podcast called "Diagnostica" which aims to bridge the gap between the culture of medicine and the "public". We'll keep you updated on this new project.

For now, enjoy a short cognitive autopsy. Next episode, more Bayesian math!

]]>37:28nofullWe'll be back soon!Wed, 14 Aug 2019 04:04:40 +0000After a season 1 that has dragged on for 4 years, we've decided to have a publishing break so we can work on more episodes. Thanks to all our listeners for your feedback and encouragement. We will be back soon!]]>After a season 1 that has dragged on for 4 years, we've decided to have a publishing break so we can work on more episodes. Thanks to all our listeners for your feedback and encouragement. We will be back soon!]]>02:05nofull55: STC live at AusDEM 2019 - MelbourneWed, 10 Jul 2019 22:35:26 +0000Apologies for the delay in getting this next episode out to you. Play along with us on this very challenging case.

Schadenfreude (/ˈʃɑːdənfrɔɪdə/; German:[ˈʃaːdn̩ˌfʁɔʏ̯də](listen); lit. 'harm-joy') is the experience of pleasure, joy, or self-satisfaction that comes from learning of or witnessing the troubles, failures, or humiliation of another.

]]>Apologies for the delay in getting this next episode out to you. Play along with us on this very challenging case.

Schadenfreude (/ˈʃɑːdənfrɔɪdə/; German: [ˈʃaːdn̩ˌfʁɔʏ̯də] (listen); lit. 'harm-joy') is the experience of pleasure, joy, or self-satisfaction that comes from learning of or witnessing the troubles, failures, or humiliation of another.

]]>51:08nofull54: STC with Gurpreet DhaliwalTue, 28 May 2019 16:00:00 +0000A special edition of STC! This time our good friend of the podcast Gurpreet Dhaliwal, master diagnostician, works through a case with Nic. The case was originally presented to Art at morning report by one of our registrars Luke Sutherland.]]>A special edition of STC! This time our good friend of the podcast Gurpreet Dhaliwal, master diagnostician, works through a case with Nic. The case was originally presented to Art at morning report by one of our registrars Luke Sutherland.]]>49:59nofull53: The Medical Futurist - Bertalan MeskoTue, 07 May 2019 09:51:41 +0000Enjoy part 2 of our conversation with Bertalan Mesko, the Medical Futurist. Apparently in 20 years when we're ready to retire, work will be so satisfying we won't want to leave! I hope Bertalan's optimism turns out to be prophetic...]]>Enjoy part 2 of our conversation with Bertalan Mesko, the Medical Futurist. Apparently in 20 years when we're ready to retire, work will be so satisfying we won't want to leave! I hope Bertalan's optimism turns out to be prophetic...]]>45:35nofull52: The Medical Futurist - Bertalan MeskoMon, 22 Apr 2019 03:54:50 +0000Join us for part 1 of our conversation with Bertalan Mesko, also known as The Medical Futurist. Bertalan is helping the medical world integrate and adopt technologies that are helping humans deliver better healthcare. Enjoy!]]>Join us for part 1 of our conversation with Bertalan Mesko, also known as The Medical Futurist. Bertalan is helping the medical world integrate and adopt technologies that are helping humans deliver better healthcare. Enjoy!]]>26:48nofull51: STC International FLIPPED - The Answer...Tue, 26 Mar 2019 00:07:47 +0000Hopefully you had a chance to mull over the case we published in the last episode about Peggy from Australia who was experiencing fatigue and weight loss. In this episode we review some of your responses and give you the final diagnosis.]]>Hopefully you had a chance to mull over the case we published in the last episode about Peggy from Australia who was experiencing fatigue and weight loss. In this episode we review some of your responses and give you the final diagnosis.]]>19:23nofull50: STC internation - FLIPPEDThu, 14 Mar 2019 09:01:04 +0000Please join the IMreasoning community and try to solve this case! Art and Nic had a cognitive/technical failure and messed up the sound files when they tried to solve this case. So this time, you get to be the chump. Good luck!]]>Please join the IMreasoning community and try to solve this case! Art and Nic had a cognitive/technical failure and messed up the sound files when they tried to solve this case. So this time, you get to be the chump. Good luck!]]>08:54nofull49: The Racist Patient - Part 2Tue, 12 Feb 2019 07:31:02 +0000Enjoy part 2 of our conversations about the racist patient. In this episode we have a conversation with professor of medical ethics, Dr. Phillipa Malpas from the University of Auckland.]]>Enjoy part 2 of our conversations about the racist patient. In this episode we have a conversation with professor of medical ethics, Dr. Phillipa Malpas from the University of Auckland.]]>50:47nofull48: The Racist PatientTue, 15 Jan 2019 23:47:50 +0000Join Art and Nic for a discussion about our experiences with patients who hold bigoted, intolerant, racist, and judgmental opinions about their providers and people in general.]]>Join Art and Nic for a discussion about our experiences with patients who hold bigoted, intolerant, racist, and judgmental opinions about their providers and people in general.]]>48:44nofull47: Compassion - Tony Fernando - RebroadcastFri, 14 Dec 2018 07:44:01 +0000This is one of favourite episodes of all time. "All time" being since August 2015... Have we really produced enough episodes to justify a "rebroadcast"? possibly not, but we're doing it anyway.

We're working on a couple of episodes that we'll have out in the new year, but we didn't want to let so much time pass without seeing you all again. Enjoy!

]]>This is one of favourite episodes of all time. "All time" being since August 2015... Have we really produced enough episodes to justify a "rebroadcast"? possibly not, but we're doing it anyway.

We're working on a couple of episodes that we'll have out in the new year, but we didn't want to let so much time pass without seeing you all again. Enjoy!

]]>01:05:07nofull46: STC International - WisconsinSat, 24 Nov 2018 19:40:31 +0000Join us for another installation of STC international, this time with a case from Adam Clements from Wisconsin.]]>Join us for another installation of STC international, this time with a case from Adam Clements from Wisconsin.]]>52:06nofull45: A Cognitive Autopsy of a case of back painThu, 11 Oct 2018 01:16:04 +0000This is by listener request! Art and Nic analyse what went wrong in the case of man who presented with sudden onset back pain. ]]>This is by listener request! Art and Nic analyse what went wrong in the case of man who presented with sudden onset back pain. ]]>50:54nofull44: Swiss RuminationsFri, 14 Sep 2018 20:05:48 +0000An "In-between-isode". Art and Nic discuss lessons from the conferences in Switzerland, Association of Medical Educators of Europe (AMEE) and the European Diagnostic Error in Medicine Conference (EuroDEM). We also discuss Argentinian Parrilla's...]]>An "In-between-isode". Art and Nic discuss lessons from the conferences in Switzerland, Association of Medical Educators of Europe (AMEE) and the European Diagnostic Error in Medicine Conference (EuroDEM). We also discuss Argentinian Parrilla's...]]>45:57nofull43: STC live in PerthWed, 01 Aug 2018 01:23:13 +0000Back with another instalment of STC live, this time from Perth, Australia. The Australian Medical Student Association put on a fantastic conference with truly inspiring speakers. We had so much fun sharing the stage with Michelle Johnston, ED doctor and author, who brought the humour and the grace to our session. Play along as the case evolves and see if you can do better than us!]]>Back with another instalment of STC live, this time from Perth, Australia. The Australian Medical Student Association put on a fantastic conference with truly inspiring speakers. We had so much fun sharing the stage with Michelle Johnston, ED doctor and author, who brought the humour and the grace to our session. Play along as the case evolves and see if you can do better than us!]]>47:06nofull42: Becoming an Expert DiagnosticianTue, 03 Jul 2018 00:24:39 +0000We chat once again with Gurpreet Dhaliwal, this time about what it takes to become a master diagnostician. We discuss the main strategies; seeing many cases, deliberate training, getting feedback, closing the loop, and others.]]>We chat once again with Gurpreet Dhaliwal, this time about what it takes to become a master diagnostician. We discuss the main strategies; seeing many cases, deliberate training, getting feedback, closing the loop, and others.]]>54:06nofull41: WordsWed, 23 May 2018 08:45:24 +0000We discuss the importance of the words that we choose to use in our medical documentation. Words matter! They can generate stigma, and they can bias the decisions we subsequently make as practitioners.]]>We discuss the importance of the words that we choose to use in our medical documentation. Words matter! They can generate stigma, and they can bias the decisions we subsequently make as practitioners.]]>42:34nofull40: Stump the Chumps International - Rahul GandhiFri, 06 Apr 2018 21:55:10 +0000It was a pleasure to finally get back to case-solving! Enjoy another interesting case of STC with our friend and colleague Rahul Gandhi, who is galavanting around the world getting super smart, so he can fix everything.]]>It was a pleasure to finally get back to case-solving! Enjoy another interesting case of STC with our friend and colleague Rahul Gandhi, who is galavanting around the world getting super smart, so he can fix everything.]]>58:08nofull40: Stump the Chumps International - Rahul GandhiFri, 06 Apr 2018 21:55:07 +0000It was a pleasure to finally get back to case-solving! Enjoy another interesting case of STC with our friend and colleague Rahul Gandhi, who is galavanting around the world getting super smart, so he can fix everything.]]>It was a pleasure to finally get back to case-solving! Enjoy another interesting case of STC with our friend and colleague Rahul Gandhi, who is galavanting around the world getting super smart, so he can fix everything.]]>full39: The Case of Dr. Hadiza Bawa-GarbaWed, 14 Mar 2018 03:59:21 +0000Some of you may have heard of the double tragedy involving Jack Adcock, a six year old who died from sepsis and Dr. Bawa-Garba, a pediatric trainee in the UK convicted of manslaughter in relation to his death and prevented from ever working again. Justice or a clear case of scapegoating?

Listen as we discuss this troubling case and its far-reaching implications for transparency, honest reflection, and patient safety.

]]>Some of you may have heard of the double tragedy involving Jack Adcock, a six year old who died from sepsis and Dr. Bawa-Garba, a pediatric trainee in the UK convicted of manslaughter in relation to his death and prevented from ever working again. Justice or a clear case of scapegoating?

Listen as we discuss this troubling case and its far-reaching implications for transparency, honest reflection, and patient safety.

]]>01:03:44yesfull38: Uncertainty in MedicineWed, 21 Feb 2018 03:09:12 +0000We're back after a long summer break. Enjoy this episode on uncertainty in medicine. We talk to Arabella Simpkin, an English paediatrician, working in Boston, who spends a lot of time thinking and writing about uncertainty and our need to embrace it, or at the very least, tolerate it graciously.]]>We're back after a long summer break. Enjoy this episode on uncertainty in medicine. We talk to Arabella Simpkin, an English paediatrician, working in Boston, who spends a lot of time thinking and writing about uncertainty and our need to embrace it, or at the very least, tolerate it graciously.]]>52:37nofull37: STC International Live on FacebookThu, 14 Dec 2017 20:23:25 +0000If you missed us live on Facebook last week, here's you chance to catch up. Enjoy our STC session. The case is from Australia, sent to us by Elise Perger (Allan) and Alison Miller... and we invited Chang as a guest host, back by popular demand.

]]>If you missed us live on Facebook last week, here's you chance to catch up. Enjoy our STC session. The case is from Australia, sent to us by Elise Perger (Allan) and Alison Miller... and we invited Chang as a guest host, back by popular demand.

]]>01:05:22nofull36: Live STC at MMCTue, 14 Nov 2017 18:22:53 +0000Enjoy our live Stump the Chumps at Main Medical Centre. We were honoured to be invited by Bob Trowbridge and it was a pleasure to visit Portland, Maine.]]>Enjoy our live Stump the Chumps at Main Medical Centre. We were honoured to be invited by Bob Trowbridge and it was a pleasure to visit Portland, Maine.]]>46:46nofull35: Turning the Wheel 2 Sun, 29 Oct 2017 00:37:02 +0000Part two of our exploration of the connections between art, artistic thinking, creativity, with clinical reasoning and diagnosis.

We speak to Alexa Miller, a medical educator who uses arts-based learning and visual thinking skills to train students and seasoned professionals alike to better observe, describe, communicate, and to tolerate uncertainty.

We also speak with Jay Baruch, a writer, medical educator, and emergency doctor who is also the director the clinical arts and humanities at Brown Medical School.

]]>Part two of our exploration of the connections between art, artistic thinking, creativity, with clinical reasoning and diagnosis.

We speak to Alexa Miller, a medical educator who uses arts-based learning and visual thinking skills to train students and seasoned professionals alike to better observe, describe, communicate, and to tolerate uncertainty.

We also speak with Jay Baruch, a writer, medical educator, and emergency doctor who is also the director the clinical arts and humanities at Brown Medical School.

]]>01:03:41nofull34: Tackling the drivers that lead to diagnostic errorTue, 17 Oct 2017 18:03:02 +0000Another enjoyable Diagnostic Error in Medicine conference, this time in Art's home town of Boston (actually, Newton...). In this episode we discuss our thoughts inspired by one of the sessions, run by Doug Salvador and Harry Hoar from Baystate Medical Centre. They addressed how to get one's own hospital administration to engage in Diagnostic Error. Remember to check the website IMreasoning.com for the attachment so you can follow along while you listen.]]>Another enjoyable Diagnostic Error in Medicine conference, this time in Art's home town of Boston (actually, Newton...). In this episode we discuss our thoughts inspired by one of the sessions, run by Doug Salvador and Harry Hoar from Baystate Medical Centre. They addressed how to get one's own hospital administration to engage in Diagnostic Error. Remember to check the website IMreasoning.com for the attachment so you can follow along while you listen.]]>35:21nofull33: Turning the WheelFri, 06 Oct 2017 20:08:26 +0000This is part one of a two-part series exploring the deep connections between creative thinking and clinical reasoning. We discuss Art's and Glenn's work as poets and physicians, and how each endeavour enriches the other.]]>This is part one of a two-part series exploring the deep connections between creative thinking and clinical reasoning. We discuss Art's and Glenn's work as poets and physicians, and how each endeavour enriches the other.]]>36:21nofull32: STC with ChangMon, 11 Sep 2017 04:03:17 +0000Enjoy an episode of STC. This time WE weren't in the hot seat! Humbling to see an excellent trainee in action.]]>Enjoy an episode of STC. This time WE weren't in the hot seat! Humbling to see an excellent trainee in action.]]>57:59nofull31: STC International with Genevieve YatesTue, 08 Aug 2017 23:25:52 +0000We finally got the chance to collaborate with Genevieve on her case for STC. And we were keen to get this out just before GPTEC. Enjoy!]]>We finally got the chance to collaborate with Genevieve on her case for STC. And we were keen to get this out just before GPTEC. Enjoy!]]>01:00:04nofull30: Diagnostic UncertaintyThu, 27 Jul 2017 11:08:12 +0000We were privileged to speak to one of our patients, recently treated by our service, about her experience while her doctors struggled with diagnostic uncertainty. The usual suspects were at play; uncommon diagnoses, uncommon presentations, cognitive biases, systems issues, etc.

Check out the new look to our website! www.imreasoning.com

]]>We were privileged to speak to one of our patients, recently treated by our service, about her experience while her doctors struggled with diagnostic uncertainty. The usual suspects were at play; uncommon diagnoses, uncommon presentations, cognitive biases, systems issues, etc.

Check out the new look to our website! www.imreasoning.com

]]>48:11nofull29: STC live! at the Australian DEMThu, 22 Jun 2017 06:24:42 +0000This time, we did not have a pause button! and we could not edit out all the times we sounded a little thick. So enjoy the raw experience. We did!]]>This time, we did not have a pause button! and we could not edit out all the times we sounded a little thick. So enjoy the raw experience. We did!]]>49:40no28: Donald RedelmeierWed, 17 May 2017 09:26:10 +0000Coined by the New York Times as the "leading debunker of preconceived notions in the medical world", Don Redelmeier is an award winning researcher, teacher, and clinician. Enjoy our conversation with Dr. Redelmeier where we discuss pitfalls in clinical reasoning...as well as New Zealand idioms...

]]>Coined by the New York Times as the "leading debunker of preconceived notions in the medical world", Don Redelmeier is an award winning researcher, teacher, and clinician. Enjoy our conversation with Dr. Redelmeier where we discuss pitfalls in clinical reasoning...as well as New Zealand idioms...

]]>48:51no27: STC International with Casey ParkerMon, 17 Apr 2017 10:28:16 +0000Finally, our first STC International. An interesting case from Broome, Western Australia. Thanks Casey Parker.]]>Finally, our first STC International. An interesting case from Broome, Western Australia. Thanks Casey Parker.]]>49:24no26: STC from the Clinical Problem-Solving series in NEJMWed, 15 Mar 2017 22:56:13 +0000While waiting for another of our home-grown cases we decided to do a STC using a published case from the Clinical Problem-Solving series of the New England Journal of Medicine.

or now you can make noise at us on Twitter. Our handle is @IMreasoning

]]>40:20no25: Revisiting Dual Process ThinkingMon, 20 Feb 2017 19:44:08 +0000Do all diagnostic errors occur because we're rushing, and prematurely jumping to conclusions? Can we course-correct by simply slowing down and by being mindful of our own inherent biases?

Geoff Norman and his colleagues review the literature to try to answer these and other questions about where errors in clinical reasoning come from.

]]>34:47no24: Myths part 2Wed, 11 Jan 2017 08:52:04 +0000Doctors should always strive to present themselves as unbreakable to their patients... All doctors are smart... All patients have a definitive diagnosis...

Believe it or not, versions of these ideas, and many others, are pervasive in our medical education institutions, and to varying degrees are believed and practiced by doctors everywhere.

In this episode we poke fun and debunk our favourite "useless" physical exam manoeuvres that we continue to teach our medical students. We couldn't cover all of them in one go, so stay tuned for more...

Try the app DxLogic on the iPhone to have a quick reference to the utility of many studied history features and physical exam manoeuvres.

Also, check out JAMA's series of articles entitled "The Rational Clinical Exam".

]]>Transillumination of the sinuses? shifting dullness? the puddle sign?

In this episode we poke fun and debunk our favourite "useless" physical exam manoeuvres that we continue to teach our medical students. We couldn't cover all of them in one go, so stay tuned for more...

Try the app DxLogic on the iPhone to have a quick reference to the utility of many studied history features and physical exam manoeuvres.

Also, check out JAMA's series of articles entitled "The Rational Clinical Exam".

This is a very well-organised, relevant, and creative conference, and it just gets better every year. Consider attending the next DEM conference. Either in Boston in one year, or come to visit our neck of woods for the first Australasian DEM in Melbourne in May! You can get more information on the SIDM website:

]]>Enjoy a short episode where we bring you our highlights of the DEM2016 conference in Hollywood, Los Angeles.

This is a very well-organised, relevant, and creative conference, and it just gets better every year. Consider attending the next DEM conference. Either in Boston in one year, or come to visit our neck of woods for the first Australasian DEM in Melbourne in May! You can get more information on the SIDM website:

Also, if you have a chance you could rate us on iTunes to help spread the good word...

]]>44:38no20: Medicine in Denial - Part 2Fri, 23 Sep 2016 23:55:16 +0000As promised, today's episode brings you an interview with Dr. Larry Weed. We hear from the man himself about his vision for a healthcare revolution.

We would love to hear from you about this episode. Do you think we are doing things right? Or do you think the way we go about diagnosis is fundamentally wrong?

]]>As promised, today's episode brings you an interview with Dr. Larry Weed. We hear from the man himself about his vision for a healthcare revolution.

We would love to hear from you about this episode. Do you think we are doing things right? Or do you think the way we go about diagnosis is fundamentally wrong?

]]>48:01no19: Medicine in Denial? - an introduction to Dr. Larry WeedMon, 05 Sep 2016 09:30:28 +0000This is part 1 of 2 where we explore the work of Dr. Lawrence Weed. If you haven't already, before you listen to this episode, have a look at his 1971 Grand Rounds lecture to an audience at Emory University.

https://www.youtube.com/watch?v=qMsPXSMTpFI

]]>This is part 1 of 2 where we explore the work of Dr. Lawrence Weed. If you haven't already, before you listen to this episode, have a look at his 1971 Grand Rounds lecture to an audience at Emory University.

https://www.youtube.com/watch?v=qMsPXSMTpFI

]]>26:14no18: STC 4 with Becky LaneWed, 13 Jul 2016 06:41:37 +0000Enjoy another instalment of Stump the Chumps. Our good friend and colleague Becky Lane challenged us with a very interesting presentation of a young man.

]]>33:57no16: Feedback 2 - just an end-of-run evaluationTue, 17 May 2016 18:26:41 +0000We decided to call this episode an "in-between-isode", borrowing the term from the Tim Ferris show. Its a short follow up continuing with our theme of feedback. How do we provide an evaluation for a strong performer? Does it help them to hear how great they are? Will it be a useful session? Will it help them improve even further?

]]>We decided to call this episode an "in-between-isode", borrowing the term from the Tim Ferris show. Its a short follow up continuing with our theme of feedback. How do we provide an evaluation for a strong performer? Does it help them to hear how great they are? Will it be a useful session? Will it help them improve even further?

]]>17:40no15: FeedbackSun, 08 May 2016 18:55:45 +0000In this episode we begin our foray into the topic of feedback. You will hear us "worry out loud", together with our guest Dr. Chris Watling from the University of Western Ontario, about the difficulties in giving effective feedback to our trainees.

Several themes arise from our conversation. Feedback needs to be specific, credible, and not soul-destroying (although ironically, we each shared some of our most traumatic feedback experiences as the most memorable, and influential, course-correcting moments). How we give and receive feedback is not only dependent on the individuals involved, but also importantly on the culture of the discipline; medical training culture is different from musical training, different from athletic training.

Also, keep an "ear" out for our new segment, the BOM (Bias of the Month). Enjoy!

]]>In this episode we begin our foray into the topic of feedback. You will hear us "worry out loud", together with our guest Dr. Chris Watling from the University of Western Ontario, about the difficulties in giving effective feedback to our trainees.

Several themes arise from our conversation. Feedback needs to be specific, credible, and not soul-destroying (although ironically, we each shared some of our most traumatic feedback experiences as the most memorable, and influential, course-correcting moments). How we give and receive feedback is not only dependent on the individuals involved, but also importantly on the culture of the discipline; medical training culture is different from musical training, different from athletic training.

Also, keep an "ear" out for our new segment, the BOM (Bias of the Month). Enjoy!

]]>58:53no14: Cognitive Autopsy of a groin lumpMon, 21 Mar 2016 02:38:14 +0000We're trying something new this week. We go through a case of a diagnostic error with a fine tooth comb to try to find the cognitive pitfalls. We would love to hear your feedback about this episode. Should we do this again?]]>We're trying something new this week. We go through a case of a diagnostic error with a fine tooth comb to try to find the cognitive pitfalls. We would love to hear your feedback about this episode. Should we do this again?]]>52:53no13: Stump the Chumps - take 3Tue, 16 Feb 2016 02:59:10 +0000Finally, our much awaited third try with Stump the Chumps. This time one of our registrars Dr. Brian Grainger challenges us with a case of a young patient. This is a longer episode, which I guess reflects the fact that sometimes, when the diagnosis is not obvious, you just have to take your time. Enjoy!]]>Finally, our much awaited third try with Stump the Chumps. This time one of our registrars Dr. Brian Grainger challenges us with a case of a young patient. This is a longer episode, which I guess reflects the fact that sometimes, when the diagnosis is not obvious, you just have to take your time. Enjoy!]]>56:35no12: Compassion in HealthcareWed, 06 Jan 2016 01:47:24 +0000What is compassion fatigue? Can you learn how to be more compassionate with your patients? We talk to Dr. Tony Fernando, psychiatrist, sleep specialist, educator and researcher, about compassion in healthcare, happiness, mindfulness, enlightenment, buddhist monks, and a bunch of other stuff. Enjoy!]]>What is compassion fatigue? Can you learn how to be more compassionate with your patients? We talk to Dr. Tony Fernando, psychiatrist, sleep specialist, educator and researcher, about compassion in healthcare, happiness, mindfulness, enlightenment, buddhist monks, and a bunch of other stuff. Enjoy!]]>01:05:43no11: Stump the Chumps - take 2Thu, 26 Nov 2015 03:30:42 +0000We bring you our second attempt at "stump the chumps". Our friend and colleague Oliver Menzies brought an interesting case. We think this case was not quite as enigmatic as our first one (episode 5) but we hope it illustrates sound clinical reasoning as we work our way through the clinical information. Enjoy.]]>We bring you our second attempt at "stump the chumps". Our friend and colleague Oliver Menzies brought an interesting case. We think this case was not quite as enigmatic as our first one (episode 5) but we hope it illustrates sound clinical reasoning as we work our way through the clinical information. Enjoy.]]>25:10no10: The Second VictimTue, 03 Nov 2015 00:47:06 +0000When we talk about medical errors, we need to remember that there are two victims; the patient who suffers harm as a result of the error, and the clinician who makes the error. As long as the practice of medicine remains a human endeavour, medical errors are inevitable. As a medical community we need to accept that errors will occur. We need to talk about them openly and honestly, share our own stories, and support our colleagues when they share their stories with us. As members of society, we should better understand the fallibility of medical practitioners, and we need to understand the limits of their craft.

We had the opportunity to interview Brian Goldman, an ED doctor from Toronto, Canada, who is also a journalist, host of the CBC radio show "White Coat, Black Art", author of two books unveiling the secrets of medical culture, and a "TED-talker" with his presentation entitled "Doctors make mistakes - can we talk about that".

We also interviewed our friend and colleague, Dr. David Spriggs, a Brit who has lived in NZ for many years, an excellent general internist and geriatrician, who regularly teaches our trainees on the reality of making mistakes.

]]>When we talk about medical errors, we need to remember that there are two victims; the patient who suffers harm as a result of the error, and the clinician who makes the error. As long as the practice of medicine remains a human endeavour, medical errors are inevitable. As a medical community we need to accept that errors will occur. We need to talk about them openly and honestly, share our own stories, and support our colleagues when they share their stories with us. As members of society, we should better understand the fallibility of medical practitioners, and we need to understand the limits of their craft.

We had the opportunity to interview Brian Goldman, an ED doctor from Toronto, Canada, who is also a journalist, host of the CBC radio show "White Coat, Black Art", author of two books unveiling the secrets of medical culture, and a "TED-talker" with his presentation entitled "Doctors make mistakes - can we talk about that".

We also interviewed our friend and colleague, Dr. David Spriggs, a Brit who has lived in NZ for many years, an excellent general internist and geriatrician, who regularly teaches our trainees on the reality of making mistakes.

]]>39:38no9: The Human Diagnosis ProjectThu, 15 Oct 2015 21:35:45 +0000The future is coming. In this episode we talk to Shantanu Nundy of the Human Diagnosis Project (HumanDx). As Shantanu describes it, HumanDx is a worldwide effort to map any health problem to its possible diagnoses. We have come across various projects that aim to create that elusive, high-fidelity, real-life, artificial intelligence of diagnosis. HumanDx is building that AI by connecting the knowledge, experience, and real-life cases from all of us. This is OUR project. We think that HumanDx is the real thing. Enjoy!]]>The future is coming. In this episode we talk to Shantanu Nundy of the Human Diagnosis Project (HumanDx). As Shantanu describes it, HumanDx is a worldwide effort to map any health problem to its possible diagnoses. We have come across various projects that aim to create that elusive, high-fidelity, real-life, artificial intelligence of diagnosis. HumanDx is building that AI by connecting the knowledge, experience, and real-life cases from all of us. This is OUR project. We think that HumanDx is the real thing. Enjoy!]]>46:57no8: DEM conference - Day 3Wed, 30 Sep 2015 04:36:06 +0000The Diagnostic Error in Medicine Conference 2015 has finally come! We have been looking forward to attending this conference for a while now. This comes on the heels of the freshly published Institute of Medicine Report on diagnostic error, an initiative which was prompted by SIDM, with Mark Graber at the helm. These three episodes, 6, 7, and 8 are our end-of-day reflections on the presentations we have heard.

Don't forget to post your comments on our website imreasoning.com, in particular about your thoughts on the IOM's definition of a diagnostic error.

]]>The Diagnostic Error in Medicine Conference 2015 has finally come! We have been looking forward to attending this conference for a while now. This comes on the heels of the freshly published Institute of Medicine Report on diagnostic error, an initiative which was prompted by SIDM, with Mark Graber at the helm. These three episodes, 6, 7, and 8 are our end-of-day reflections on the presentations we have heard.

Don't forget to post your comments on our website imreasoning.com, in particular about your thoughts on the IOM's definition of a diagnostic error.

]]>35:08no7: DEM conference - Day 2Wed, 30 Sep 2015 04:31:14 +0000The Diagnostic Error in Medicine Conference 2015 has finally come! We have been looking forward to attending this conference for a while now. This comes on the heels of the freshly published Institute of Medicine Report on diagnostic error, an initiative which was prompted by SIDM, with Mark Graber at the helm. These three episodes, 6, 7, and 8 are our end-of-day reflections on the presentations we have heard.

Don't forget to post your comments on our website imreasoning.com, in particular about your thoughts on the IOM's definition of a diagnostic error.

]]>The Diagnostic Error in Medicine Conference 2015 has finally come! We have been looking forward to attending this conference for a while now. This comes on the heels of the freshly published Institute of Medicine Report on diagnostic error, an initiative which was prompted by SIDM, with Mark Graber at the helm. These three episodes, 6, 7, and 8 are our end-of-day reflections on the presentations we have heard.

Don't forget to post your comments on our website imreasoning.com, in particular about your thoughts on the IOM's definition of a diagnostic error.

]]>32:41no6: Diagnostic Error in Medicine conference 2015 - Day 1Wed, 30 Sep 2015 04:23:06 +0000The Diagnostic Error in Medicine Conference 2015 has finally come! We have been looking forward to attending this conference for a while now. This comes on the heels of the freshly published Institute of Medicine Report on diagnostic error, an initiative which was prompted by SIDM, with Mark Graber at the helm. These three episodes, 6, 7, and 8 are our end-of-day reflections on the presentations we have heard.

Don't forget to post your comments on our website imreasoning.com, in particular about your thoughts on the IOM's definition of a diagnostic error.

]]>The Diagnostic Error in Medicine Conference 2015 has finally come! We have been looking forward to attending this conference for a while now. This comes on the heels of the freshly published Institute of Medicine Report on diagnostic error, an initiative which was prompted by SIDM, with Mark Graber at the helm. These three episodes, 6, 7, and 8 are our end-of-day reflections on the presentations we have heard.

Don't forget to post your comments on our website imreasoning.com, in particular about your thoughts on the IOM's definition of a diagnostic error.

]]>29:51no5: Stump the ChumpsMon, 07 Sep 2015 02:18:44 +0000As promised, we bring you our first attempt at "stump the chumps". This is where we are presented with a challenging diagnostic case and we think out loud as we reason our way through it. You can play along as you hear the case unfold.]]>As promised, we bring you our first attempt at "stump the chumps". This is where we are presented with a challenging diagnostic case and we think out loud as we reason our way through it. You can play along as you hear the case unfold.]]>42:49nopresentation,case,stump,chump4: Wise Words from Gurpreet DhaliwalSat, 08 Aug 2015 20:16:20 +0000Dr. Gurpreet Dhaliwal is professor of clinical medicine at UCSF and has written many articles in the realm of clinical reasoning. Although you have already heard snippets of our conversation on prior episodes, we thought we would share the entire interview with all of you. Gurpreet has an enlightening way of explaining how we think, and how we move from good clinicians to expert clinicians, through extended problem-solving and feedback.]]>Dr. Gurpreet Dhaliwal is professor of clinical medicine at UCSF and has written many articles in the realm of clinical reasoning. Although you have already heard snippets of our conversation on prior episodes, we thought we would share the entire interview with all of you. Gurpreet has an enlightening way of explaining how we think, and how we move from good clinicians to expert clinicians, through extended problem-solving and feedback.]]>41:30no3: Differential Diagnosis and Problem RepresentationSat, 01 Aug 2015 02:56:01 +0000The differential diagnosis is at the heart of analytic thinking for the diagnostician. Dr. Mark Graber agrees. As the founder of the Society to Improve Diagnosis in Medicine, he should know. It can overcome many of the biases we are prone to when we limit ourselves only to diagnosis by pattern recognition. We discuss some simple approaches to generating a differential diagnosis and developing a problem representation.]]>The differential diagnosis is at the heart of analytic thinking for the diagnostician. Dr. Mark Graber agrees. As the founder of the Society to Improve Diagnosis in Medicine, he should know. It can overcome many of the biases we are prone to when we limit ourselves only to diagnosis by pattern recognition. We discuss some simple approaches to generating a differential diagnosis and developing a problem representation.]]>30:21nomark,problem,diagnosis,representation,graber,differential2: BiasesSat, 01 Aug 2015 02:38:47 +0000We continue laying the foundations of type 1 and type 2 thinking with a discussion about biases. Once again we hear from Prof. Gurpreet Dhaliwal and some of his thoughts on the utility of studying metacognition.]]>We continue laying the foundations of type 1 and type 2 thinking with a discussion about biases. Once again we hear from Prof. Gurpreet Dhaliwal and some of his thoughts on the utility of studying metacognition.]]>37:25nobias,biases,dhaliwal,gurprit,system1,system21: Setting the Stage - How Doctors ThinkMon, 27 Jul 2015 04:30:21 +0000Our first episode lays down the foundations around type 1 and type 2 thinking.]]>Our first episode lays down the foundations around type 1 and type 2 thinking.]]>25:59no0: Art and NicFri, 24 Jul 2015 18:46:20 +0000IMreasoning is a podcast about clinical reasoning, diagnosis, diagnostic error, and other relevant topics for the working doctor, for students and trainess, and anyone else with an interest in meta-cognition and education.]]>IMreasoning is a podcast about clinical reasoning, diagnosis, diagnostic error, and other relevant topics for the working doctor, for students and trainess, and anyone else with an interest in meta-cognition and education.]]>06:00no